iHealth. #cernerhaiku

> Lessismoremed

Doctors of B.C. call for collaboration and solutions on IHealth - Nanaimo News Bulletin. The president of Doctors of B.C. appealed to Island Health to work with physicians on appropriate and meaningful solutions around IHealth during a visit to Nanaimo this week.

Dr. Alan Ruddiman, whose organization represents 12,000 doctors, is encouraging collaboration between Nanaimo Medical Staff Association and Island Health on solutions that serve patients well and suggests a mediator in the event of an impasse. Members of the medical staff association have felt the order entry system of IHealth, where doctors place electronic orders for tests and medication, should be put on hold until it’s redesigned, with concerns about the safety of the system. Island Health had agreed to suspend the system, but later reversed the decision because of its connection to the rest of the electronic health record. After that move, a group of internal specialists returned to writing paper orders feeling they could no longer support the electronic computer order management process.

Dr. Dr.
Canadian Healthcare Network. Doctors’ association head calls for mediation in IHealth dispute. The president of the B.C. doctors’ professional association says it’s time to repair the fractured relationship between Nanaimo medical staff and the health authority over electronic health records.

Doctors of B.C. president Dr. Alan Ruddiman, who toured Nanaimo Regional General Hospital on Thursday, said the rift is creating an unhealthy work environment and affecting patient care. The hospital is one of the pilot sites hosting Island Health’s new IHealth system. “There has to be a solution to this and I think the road to healing and fixing this is definitely bringing the two parties to the middle. Either they do this together on their own, or perhaps they need a mediator to get through this,” Ruddiman said. Island Health CEO Brendan Carr said the health authority is not only fully on board with the idea of mediation — it has already made moves toward it. “We have been suggesting that for quite some time,” Carr said.

IHealth records system still putting patients at risk at Nanaimo hospital, doctors say. More than a year after an electronic health records system was introduced at Nanaimo Regional General Hospital, doctors say patient safety is still at risk.

Physicians and other medical staff have been raising concerns about IHealth since it was rolled out 14 months ago. Island Health planned to temporarily suspend the use of IHealth's electronic tool for ordering medications in February, following an external review that was ordered by B.C.'s health minister. But the health authority later decided it would be too difficult to safely go back to pen and paper orders. Instead, it decided it would be best to work on improvements while continuing to use the system.

Nanaimo doctors say electronic health record system unsafe, should be shut down. Implementation of a $174-million Island-wide electronic health record system in Nanaimo Regional General Hospital — set to expand to Victoria by late 2017 — is a huge failure, say senior physicians.

After a year of testing, the new paperless iHealth system rolled out in Nanaimo on March 19. Island Health heralds the system as the first in the province to connect all acute-care and diagnostic services through one electronic patient medical record, the first fully integrated electronic chart in the province. But nine weeks after startup, physicians in the Nanaimo hospital’s intensive-care and emergency departments reverted to pen and paper on Wednesday “out of concern for patient safety.”

Doctors said the system is flawed — generating wrong dosages for the most dangerous of drugs, diminishing time for patient consultation and losing critical information and orders.
$174-million IHealth system: a timeline. March 19: The $174-million IHealth system was launched at the Nanaimo hospital, Dufferin Place residential care centre in Nanaimo and Oceanside Health Centre in Parksville.

Island Health has a 10-year, $50-million deal with software developer Cerner Corp. of Kansas City, Missouri, for the electronic health record software system. Island Health will spend an additional $124 million for hardware and training. May: Physicians in the hospital’s intensive care and emergency departments reverted to pen-and-paper orders, saying that computerized orders for drugs, diagnostic tests and patient care were randomly lost or changed.
Vancouver Island health-record battle persists, one doctor suspended - The Globe and Mail. Ongoing tension over a $174-million electronic records system used by the Vancouver Island Health Authority has resulted in at least one doctor being suspended and additional physicians being recruited to cover for those who refuse to use the system.

VIHA put out a call for doctors to provide “shadow” coverage earlier this month. “As you might be aware, a cadre of General Internal Medicine physicians in Nanaimo has declared an intention not to use the [computerized provider order entry] component of the electronic health record, in contravention of Island Health policy,” VIHA’s executive medical director, Dr. Jennifer Grace, said in a May 4 letter addressed to “internal medicine colleague” and provided to The Globe and Mail. Internists are specialists who look after adults with a range of complex medical conditions, including diabetes and heart disease.

One doctor was suspended for 24 hours earlier this month after he refused to use the system, citing patient-safety concerns.
Comment: Boston doctors decry electronic medical records. The controversy over electronic medical records at Nanaimo Regional General Hospital is not unique.

Three prominent doctors in Boston have gone public with their concerns over the system in use there. DRS. JOHN LEVINSON, BRUCE H. PRICE and VIKAS SAINI It happens every day, in exam rooms across the country, something that would have been unthinkable 20 years ago: Doctors and nurses turn away from their patients and focus their attention elsewhere — on their computer screens. By the time the doctor can finally turn back to her patient, she will have spent close to half of the appointment serving not the needs of her patient, but of the electronic medical record.
Canadian Healthcare Network. Use IHealth software, not paper, defiant Nanaimo doctors told. Island Health says it will no longer accommodate Nanaimo doctors who are refusing to use an electronic system for ordering medication — a system the doctors say puts patients at risk.

Nine internal medicine doctors at Nanaimo Regional General Hospital stopped using the $174-million electronic health records system at the end of April in protest. The internists join doctors in the emergency and intensive care units who went back to entering medication orders using pen and paper because of their concerns. They say some medication and test orders have disappeared, and some dosages have changed, endangering patients.
Get IHealth system right - Nanaimo News Bulletin. Re: Doctor suspended over refusal to use IHealth system, May 2.

I am compelled to write in support of the specialist for refusing to use the IHealth system. Suspension of this doctor was not only appalling but unacceptable by the Vancouver Island Health Authority. This physician was practising ethically by exercising his responsibility and commitment to care values for all patients. The reason for the IHealth system not supporting doctors’ orders is because it is continuously cancelling and overriding them. This consequently is wasting precious critical care time jeopardizing the safety of patients. VIHA should listen up to the very people trying to save lives using this system and suspend and fix the problems and constantly test in a larger centre like Victoria with more specialists in key high-traffic areas such as ER, ICU, critical care, cardiology, the hospital pharmacy, etc., until it’s foolproof.
Government computer systems seem expensive. Re: “Doctors defy IHealth, dump software,” April 28.

It never fails to amaze me how much the computer programs cost that we pay for, and how useless some seem to be. Of course, the ones in charge invariably say there is nothing wrong. It seems that one of our human failings is not to want to admit a mistake. Just keep charging ahead, regardless of consequences. Island Health says it can’t suspend use of this costly system. What did the bureaucrats think they were buying? If the program has flaws, it should be rectified by the people who sold it to Island Health.
VIDEO: B.C. Green Party leader Andrew Weaver talks health care at Nanaimo rally - Nanaimo News Bulletin. Worker input is needed with Nanaimo Regional General Hospital and ordering systems, says the B.C. Green Party. The party made a stop at Maffeo Sutton Park on Saturday, ahead of the Tuesday (May 9) general voting day, and Andrew Weaver, B.C. Green leader and Kathleen Harris, B.C. Green Nanaimo candidate, talked health care with the News Bulletin.

Some hospital staff aren’t using the IHealth computer system when ordering medication and tests, opting for the old paper system, and Harris said there needs to be more input from workers in implementation. “I was involved a little bit when they were introducing it and involved with seeing all the difficulties it presented for the people,” said Harris, a registered nurse and teacher. The implementation process needs to be done with people and not with a top-down management structure, said Harris.
Doctors are right to say no to IHealth. Editorial: IHealth project badly handled. The simmering controversy over the new patient-record system at Nanaimo Regional General Hospital has boiled over. Some physicians have abandoned the system, and gone back to using paper records for ordering medications and lab work.

They say the software is clumsy, slow and plagued by glitches. As a result, one doctor has been suspended, and another is facing disciplinary action. While the medical staff’s actions are troubling, nothing about the behaviour on either side of this dispute generates confidence. On Island Health’s part, the authority has continually been the victim of its own inept management. Initially, the CEO apologized and put parts of the project on hold until improvements could be made. The new system was introduced in March 2016.
Island Health says Nanaimo IHealth protest slowing patient care - BC Local News. By JOHN MCKINLEY April 29, 2017 · 6:44 AM Nanaimo Regional General Hospital continues to be unsettled over implementation of the electronic record keeping system IHealth, scheduled to eventually be implemented Island-wide. / John McKinley/VI Free Daiy file Nanaimo doctors breaking protocol to protest the controversial IHealth electronic record-keeping system are indirectly hurting patients, an Island Health official said Friday.

A group of internal medicine specialists at Nanaimo Regional General Hospital are refusing to use IHealth and instead are reverting to paper orders, a move they say is necessary to ensure patient safety because the system is unreliable.
Doctor says suspension over IHealth system ‘a moment of pride’
A Nanaimo doctor suspended for defying an Island Health order to use a new software, says he was acting to protect his patients’ safety. Dr. Paul Mitenko is one of seven internal medicine specialists at Nanaimo Regional General Hospital who went back to using pen and paper to order medication and tests such as X-rays and blood work, on Thursday morning.

By late morning, Mitenko said he got a phone call telling him he was suspended for 24 hours. “It’s not a moment of shame for me.
Nanaimo doctors defy IHealth, dump software; MD suspended. Some doctors at Nanaimo Regional General Hospital are abandoning an Island Health computer system in defiance of the health authority. The doctors say the IHealth system could cause dangerous drug dosage errors.

They reverted to ordering medicine and lab work using pens and paper on Thursday, after using the IHealth system for more than a year. One doctor has been suspended and another is facing disciplinary action, said Dr. David Forrest, president of the Nanaimo Medical Staff Association.
Specialist suspended after going back to paper-based orders at Nanaimo hospital - Nanaimo News Bulletin. A specialist has lost privileges at Nanaimo Regional General Hospital after a return to a paper-based ordering system, according to Dr.

David Forrest, president of Nanaimo Medical Staff Association.
IHealth alarm sounds again in Nanaimo. B.C. health-care workers slam decision to reverse IHealth suspension - The Globe and Mail. The Vancouver Island Health Authority has reversed a decision to suspend part of its $174-million IHealth electronic records system, despite concerns among some medical staff that problems – including potentially dangerous dosing errors – have not been fully addressed.
A lesson from Nanaimo on the human costs of electronic health records. Comment: Why doctors back IHealth, yet have concerns. We read with great concern the recent commentary on IHealth (“Paper health records just can’t cut it,” March 10).

Many of Dr.
Comment: Paper health records just can’t cut it. The electronic health record system that Island Health is trying to implement, along with most other B.C. health regions, has been a frequent topic in the Times Colonist, the most recent article being the editorial “Health system needed a pause,” on Feb. 28. As one who has been involved with this project for years, it is disturbing that the reporting has a bias that leaves the reader with the unfair impression that the Nanaimo fiasco is all the fault of IHealth, the agency managing this complex process, and that it is yet another grandiose government-scheme failure. Granted, IHealth and the software vendor, Cerner, deserve criticism for not engaging users effectively — especially doctors.

Editorial: Health system needed a pause. Island Health temporarily suspends troubled IHealth system. The Vancouver Island Health Authority has temporarily halted the use of its IHealth software after numerous complaints about safety and efficiency. IHealth is designed to provide complete digital charts and records for patients, but almost from the outset reports of problems came up during a test run in Nanaimo Regional General Hospital. The program will now be suspended so those problems can be addressed over a period of months.

Excessive computer use by doctors has negative impact on patient care: study. By Bill GravelandThe Canadian Press Thu., Feb. 23, 2017. Video?clipId=1062513&binId=1. Use of IHealth electronic records system suspended at Nanaimo hospital. Super Expensive Cerner Crack-up at Island Health · Paul Ramsey. 19 Feb 2017 Kansas City, we have a problem.
Island Health projects up to $12M deficit after busy holiday season. 2016 Year in Review: Complications logged with records system - Nanaimo News. Australian Health Information Technology: The Thoughtful Academic Paper Everyone Is Discussing - Time For Some More Information!
Why are doctors burned out? Our health care system is a complicated web. Comment: MDs must be iHealth partners to ensure safety. Island Health CEO apologizes in wake of report on IHealth system.